Tag: twitter

Ormskirk

Yes, Ormskirk. A little town in the North West of England, 14 miles north of Liverpool. Bus driver, pub owner, town locals…all asking me the same question: “What are you doing here?!” It seems visitors, be it from London or from Mars, are a rarity. Ormskirk is not a place that prides itself on tourism.

Doesn’t matter to me, I didn’t get to see much of the place anyway. I was here for the Continuing Professional Paramedic Development – a one day conference put on by the UK College of Paramedics.

The day started off with Dr John Freese, Chief Medical Director of New York City Emergency Medical Services. A rather good speaker with an interesting background (John started as a basic EMT in the rural US, worked his way up to Paramedic, then turned to medicine). His talk was based around trauma care in the US, its history and direction of the future. Some interesting points I picked up:

  • Skill decay is a big problem amongst NYC paramedics. Intubation success rate is approximately 30%, many paramedics don’t even get a chance of intubating, and their average training is far less than that of an average UK paramedic.
  • For severe trauma patients, definitive care is needed. Where this care is provided best (i.e. what is the most suitable hospital), NYC EMS has developed a simple reductive flow chart based on patient presentations, events and mechanism in order to determine if a patient should be taken to a trauma centre, and if so, what level. An important note was emphasised: the clinicians decision. The chart could not indicate any need for higher care, but the paramedic must still be allowed to take a patient to the highest care facility if judged so by their clinical experience.
  • Then the big one: “Spineboards: they need to go”. NYC EMS has realised that far too many patients are immobilised for no good reason. Research is proving that immobilisation is possibly doing more harm than good. Currently, new guidelines are being written in order to drastically lower numbers of spineboard usage in NYC. Personally, I applaud this. A big step in the right direction.
This talk was particularly interesting for me, as I had just visited New York last year (if you’ve been reading this blog recently, I am just putting up the stories now). Very nice having seen NYC EMS, then hearing all about it from the Chief MD.
Up next was Professor Kevin Mackway-Jones, Medical Director of the North West Ambulance Trust (NWAS). The presentation was similar to the previous, but this time from the NWAS perspective – a much more diverse landscape with urban, regional and rural settings (something you wouldn’t find in NYC!).
  • To provide a similar level of care that urban area enjoy everywhere in the NWAS catchment area, another 14 full time helicopters and anaesthetist would need to be employed. Far too expensive and ridiculous, he explored the alternatives: Full time HEMS, vs on call residential doctors, vs volunteer doctors (e.g. BASICS), vs full time specialised (critical care) paramedics. The last option won – cost effective, good exposure means good quality, experienced, available and a good skill set.
  • Kevin agreed with John about spineboards, and repeated the overuse of the device, stating that many UK services are re-evaluating their use. Additionally, he stated he is not convinced by pelvic splints; there is not enough evidence to support them.
Next speaker was Professor Andy Newton, Chair of the College of Paramedics and Clinical Director of South East Coast Ambulance Service. After some information update from the College itself, Andy got us in the right mood with a clip from the Simpsons: Homer as an Ambulance Driver (could unfortunately only find it online in Italian). Some points Andy talked about:
  • The history of Paramedicine, especially with regards to the “founder” of out of hospital care, Dominique Jean Larrey.
  • The specialisation of the workforce. The police have a very specialised workforce: General duties, traffic, homicide, fraud…certain cops target certain crime. Paramedicine should (and is) heading int he same direction: Paramedic Practitioners for minor issues that can bypass the A&E department, Critical Care Paramedics for very serious cases.
  • Apparently providing Ambulance Services in the United Kingdom costs 2 billion Pounds annually (surprising actually, since London’s Metropolitan Police alone have an annual budget of 3.5 billion Pounds. Compared to the 282 million Pound London Ambulance annual budget).
  • Then a great point: “Paramedics as a disruptive technology“. Adapted from the business world, the point was made how Paramedicine is influencing healthcare, changing the way care is delivered (e.g. via Paramedic Practitioners), together with potential ways Paramedicine may influence the provision of healthcare in the future.
  • Another video, this time from a cardiac arrest in London from the early 1980’s. Horrible grey uniforms, ghastly hairstyle, but the intubation was spot on (unfortunately nobody cared about chest compressions…). Nothing how an arrest is run in 2012, thirty years later.
After lunch, there were two more presentations; Sudden Arrhythmic Death, and Obstetric emergencies.

In other words: Quite a good event. Interesting speakers, decent venue, and a good attendance. Can’t ask for much more! For those who would like an online summary, I did tweet most of the event under the #ParaUKCPD hashtag on twitter (should be visible on my timeline, dated 19th October).

Couldn’t make it? I will be visiting the Emergency Services Show in Coventry on the 21st and 22nd of November, tweeting and blogging again. Hope to see you there!

NYC EMS: An Introduction

June 2011

What would NYC be without EMS? Only half a trip for me!

Untitled

My first encounter with an ambulance. It conveniently parked in front of me, inconveniently the fence would not move out of the picture, despite much begging and pleading on my behalf (note to self: fences a much better behaved back home).

That day, twitter came to the rescue for my evening plans. Murphy (@Murphquake) told me about the Dinner Presentation that was being put on for EMS week by the NYC Regional EMS Council. A free event? Dinner? I’m there!

And there I was. Standing there, in my lonesome, in a big hallway, people with all sorts of uniforms coming and going. I enquired politely about the evening at the entrance desk, explaining that I was a visiting Paramedic from Australia.

“AUSTRALIA!? Wow, come right in. What T-Shirt size are you? (wow, free tshirt too??). Here, grab one, head that way, the buffet is in that corner, help yourself, grab a seat anywhere you like, and enjoy the evening. Speeches etc begin in 45 minutes. Here is a guide to the evening. Enjoy yourself!”

Right, thats sorted then. I may not know anybody by face, but there is free food, lots of people in the same profession, and a few empty seats around. Jump right in, I say.

With a precariously heaped plate in each hand, I navigate myself to a table where people seem cheery enough to accommodate myself. Turns out they were a whole family dedicated to EMS, from Daughter and Son in law right through to the grandparents. We got some great insights from each others country over copious mounds of food (this is America after all), and I was asked if I was heading out on a shift in New York at all. Even before I could answer, one of them had run of to fetch ‘a friend of theirs’, who came back shortly after. I was introduced to Barry, one of the Paramedic supervisors in the Borough of Queens.

“Here’s my number. You call me tomorrow, and I’ll get ya sorted”. Spoken in a perfect New York accent.

This was going to be excellent.

Hobart – use the Hashtag! #PAConf2012

Next month, the 2012 Paramedics Australasia Conference will be held in Hobart, Tasmania. I was fortunate enough to be able to attend the 2010 and 2011 conferences (and even present at the last one), so it is a little sad that I’m missing out this time.

Two things I ask of you:

  1. Please attend the conference
  2. Please keep me up to date by live-tweeting the conference with the #PAConf2012 hashtag.

Pure selfish reasons, I know, but I do want to keep an eye on the mob Down Under, they are a good bunch!

Stalking and Subscribing…

…this blog has just become easier. I was made aware of the lack of RSS feed to subscribe to this blog, so here it is.

If you let your eyes wander to the right, you will notice I have added the opportunity to subscribe to this blog via email and via RSS. While you are over on the sidebar, you are more than welcome to pop over to my facebook page and check out my twitter link…and please check out the sponsor for EMSBlogs.com too!

Last but not least, there’s always my list of shared article from my google reader if you want to know what I read in my spare time…

OK, enough self promotion, let’s get back to this thing called paramedicine!